This five-year Community Based Therapy for Children with Cancer project is to provide optimal care for children with cancer in a rural setting. Private practitioners were trained by University based hematologist-oncologists to use high survival rate treatment protocols for childhood cancer. Following diagnosis and assignment to protocol, patients chose between being treated by private practitioners or oncologists. Telephone communication between practitioners and oncologists is continually available. Direct comparison is planned of morbidity and mortality in children receiving therapy from practitioners and children treated concurrently with the same protocols by urban teaching hospital based hematologist-oncologists located in another state. Comparisons will be made between the psychologic and social characteristics of the rural and urban patient populations. Effectiveness of the program will be judged 1) by the private practitioners' continued participation in the project, 2) by practitioners' acceptance and continued use of self-auditing patient collection and monitoring system, 3) by morbidity and mortality in all patients treated, and 4) by quality of treatment given by teaching hospital oncologists as compared to that given by private practitioners. The impact of the program will be measured by documenting changes in Iowa referral patterns, survival rates, and economic effects.